| Doctor Name: | MRS. TERESA T. BOU-MATAR |
| NPI Number: | 1023382827 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0401540 |
| Business Practice Address: | 677 25 1/2 Rd Grand Junction, CO - 815056956 |
| Business Phone Number: | 9702607017 |
| Business Fax Number: | |
| Mailing Address: | 677 25 1/2 Road, GRAND JUNCTION |
| State: | CO |
| Postal Code: | 81505 |
| Phone Number: | 9702607017 |
| Fax Number: | |
| NPI Enumeration Date: | 02/27/2012 |
| NPI Last Update Date: | 02/27/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YS0200X |
| License Number: | 0401540 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |